VD: A National Emergency

The global outbreak of syphilis and gonorrhea spawned by World War II came as no surprise to the medical world. Over the past five centuries, there had been massive flare-ups of venereal disease--the worst of them during wartime.* But the World War II epidemic was cut short by the 1945 discovery that both diseases could be cured by penicillin. The numbers of new cases reported annually in the U.S. declined through the 1950s and early 1960s, and venereologists hoped that the twin scourges would soon be wiped out.

Spectacular Rise. In recent years, however, venereal disease has been making a comeback. In 1965, Dr. William J. Brown of the U.S. Center for Disease Control declared that an estimated 650,000 Americans under 20 were annually contracting either syphilis or gonorrhea. Reported cases of syphilis in the past year have risen by 55% in New Jersey, 30% in New York City. Last week Dr. James McKenzie-Pollock of the American Social Health Association reported that there has been a "spectacular rise" in syphilis in the past five months and called for national emergency action to meet the problem.

Epidemiologists do not agree on the causes for VD's current upswing. Health authorities admit that the Viet Nam conflict has had little impact on U.S. health. Many doctors believe that the preliminary victories of penicillin over VD were oversold, and that a false sense of security was created, especially among the young. Some blame the Pill, claiming that oral contraceptives are being widely used instead of condoms. But the use of condoms has actually increased since 1960. Only one thing is certain: no one can satisfactorily explain the current epidemic.

Massachusetts disease detectives, who rank among the best organized in the nation, say that prostitutes are to blame for only about 3% of cases: "They usually know how to take pretty good care of themselves." Male homosexuality is blamed for 16% and heterosexual free love for 81%.

Silent Phase. Untreated, syphilis goes through three principal phases. The early stages may be marked at first by visible sores, later by a rash, and are highly infectious for about a year unless treated. The next is the "silent phase," when the disease is relatively noninfectious and can be detected only by blood test. This may last several years, followed by the late stage, which can cause heart damage, blindness or general paralysis.

Gonorrhea is usually considered less serious, but is more "catching." And it can be inapparent in a woman, whose only sign of infection may be a slight vaginal discharge--which might result from a multitude of other causes. A male victim is more likely to seek prompt medical help, as he will probably suffer a painful urethral discharge.

Venereal Vaccines. However they disagree on other matters, medical authorities see an answer to VD epidemics in a combination of case reporting and contact tracing. But the U.S. Government spends only $6,300,000 a year on case and contact finding; with money from the states and municipalities, used mostly for education, the total spent on VD is less than $30 million. It seems likely that neither syphilis nor gonorrhea will be eradicated until vaccines against them are prepared. But research on such preventive measures is even more starved of financial support than case finding and treatment.

*The first documented outbreak of syphilis, or "the great pox," followed the siege of Naples by the French in 1494, giving rise to the now discounted legend that Columbus' men had brought the disease back from the New World.

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